Medical Billing / Insurance Claims Specialist

 Posted 4 months ago
     
⭐ 2-5 years experience
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AI Summary

The specialist will be responsible for answering member benefit questions and reviewing member Explanation of Benefits (EOBs) and bills for accurate processing. This role also involves working closely with Third-Party Administrators (TPAs) regarding claim issues and assisting provider offices with status inquiries.

PHA Health specializes in providing high-quality, low-cost healthcare to members through our benefit plans. Our commitment to our team and clients is to provide a benefit plan for employers and their employees that is sustainable, affordable, and promotes well-being. Our team members must possess the company's core values:

  • Put People First
  • Do the Right Thing
  • Be Humbly Confident
  • Be Resilient

PHA Health is looking for a full-time Medical Billing / Insurance Claims Specialist.

Essential Duties and Responsibilities:

  • Answer member benefit questions
  • Review member EOB's and member bills to ensure accurate processing
  • Work closely with TPAs for claim processing issues
  • Assist provider offices and facilities with claims status questions
  • Data Entry
  • Filter/disperse incoming claims to appropriate TPAs
  • Create and track invoices
  • Respond to calls and emails in a timely manner
  • Provide excellent customer service

Pay: DOE

Work Location: In person or remote

Job type: Full-Time day shift Monday through Friday

Benefits

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Health insurance
  • Vision insurance
  • AFLAC benefit package
  • Paid time off

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